Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
Part IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2t cardiac arrhythmia in the United Slates and is associated with a fivefold increase in cardioembolic events 11-3]. There is a higher mortality and morbidity associated with cardioembolic strokes associated with AF compared to non-AF strokes, emphasizing the need for preventive treatment strategies Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2[4]. The left atrial appendage (LAA) has been long recognized as the primary source of thrombus formation within the cardiovascular system [4-6] and hEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
as been termed “the most lethal human attachment” [14]. In surgical patients with AF. left atrial (LA) thrombus was found in 17 % of nonrheumatic AF pPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2diography evaluation of patients undergoing cardioversion where LA thrombus is predominantly located in the LA A [8-10J. These observations led to the hypothesis that closure of the LAA would prevent thrombus formation, prevent cardioembolic events, and reduce mortality.The concept of excluding the Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2LAA during mitral valve surgery existed since the 1930s [5. 6] and has become an integral part of the American College of Cardiology/American Heart AsEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
sociation guidelines for mitral valve surgery to reduce the stroke risk [ 11. 12]. LAA exclusion is also an essential part of the Maze procedure for bPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2cutaneous Left Atrial Appendage Transcatheter Occlusion) device was conceived and developed based on the premise that if the appendage could beR.J. Lee. M.D.. Ph D. (El)University of California. San Francisco. 500 Parnassus Ave, San Francisco. CA. 94010. USA e-mail: Randall.Lee@ucsf.edu© Springer In Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2ternational Publishing Switzerland 2016135J. Saw et al. (eds.l. Left Atrial Appendage Closure. Contemporary Cardiology.nni in inm/nio oom U1ỬA < n136REbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
..I. Leeobliterated by a simple, minimally invasive technique, it would provide an alternative strategy for preventing stroke in patients with nonrheuPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2elivery system (Appriva Medical, Palo Alto. CA/EV3 Inc.. Plymouth. Minnesota). The PLAATO device was the first and prototypical LAA occlusion device. The PLAATO device was developed with the following specifications [ 14|. The device could not be allowed to: (1) dislodge and embolize, or migrate fro Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2m its implanted position, (2) erode into the pericardial space or other surrounding structures (such as the circumflex coronary artery). (3) interfereEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
with atrial function or blood How through the mitral valve or from the pulmonary vein. (4) be the source of emboli. Additionally, the procedure had tPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2here had to be a way to collapse and completely remove and replace a given device with another size device.The PLAATO device consists of a self-expanding nitinol metal cage structure with multiple outwardly bent struts and covered with the occlusive membrane of polytetrafluoroethylene ePTFE (Fig. 9. Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 21). The 14 Fr transseptal delivery system allows for collapse and repositioning or complete removal of the PLAATO device in the event a different sizeEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
device (15-32 mm) is required to replace the implant with a different size.Fig. 9.1 PLAATO device composed of a nitinol collapsible cage structure coPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2LAATO Device137Preclinical Studiesrhe seminal proof of principle study was completed at the University of California. San Francisco [141- This study was the first demonstration that a LAA occlusion device could be successfully implanted into the LA A with endothelial ization of the PLAATO device (Fi Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2g. 9.2). The study objectives were to demonstrate feasibility, safety, and healing characteristics of the percutaneous transseptal delivery of the PLAEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
ATO device to occlude the LAA.Twenty-five dogs underwent successful implantation of the PLAATO device into the LAA. Conformation of proper placement oPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2 of the device with the exception of a small pericardial effusion that did not need treatment. Animals were sacrificed for histological examination on day 2, 2 weeks. I and .3 months. In one animal, there was evidence of a small perforation of the tissue anchor w ith no other abnormality noted. At I Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2 and .3 months, there was complete closure of the LA A with demonstration of1 month3 monthsFig. 9.2 Prcclinical postmortem analysis. The top panel ofEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
ligures arc the gross anatomy at I and 3 months, demonstrating the snug tit of the implant into the LA A orifice. Adapted from Nakai et al. 114] with Part IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalent Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2l LA angiogram delineating the LAA (a) and after the implantation of PLAATO device (b) demonstrating complete occlusion of the LAA. Corroboration of the contrast fluoroscopy is provided by TEE imaging. The top upper left figure (c) is the pre-implant image of the LAA. (d) It is the visualization of Ebook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2the PLAATO device seated in the LAA. (e. f) Shows the same TEE view's I and 6 months after the implantation. Adapted from Nakai et al. 124J w ith permEbook Left atrial appendage closure - Mechanical approaches to stroke prevention in atrial fibrillation: Part 2
ission from Pacing Clin ElectrophysiologyR..I. Lee(a) Pre Implant(b) Post Implant(c) 1 month(d) 6monthsendothelialization of the atrial surface of thePart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalentPart IVPercutaneous LAA ClosureDevices and Trial ResultsChapter 9PLAATO DeviceRandall J. LeeIntroductionAtrial fibrillation (AF) is the most prevalentGọi ngay
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